Interobserver Variability using the ILO (1980) Classification in Subjects Referred for Compensation Evaluation.
Delclos-GL; Wilson-RK; Bradley-BL
NIOSH 1990 Nov:960-964
A study of interobserver variability in classifying radiographic small opacities in subjects with possible asbestos (1332214) associated lung impairment according to the 1980 International Labour Office (ILO) system was conducted. Chest X-rays obtained from 469 persons, mean age 55.9 years, referred for evaluation of possible asbestos related disability during the period July 1, 1981 to June 30, 1986 comprised the study group. Fifty two subjects had a history of silica (14808607) exposure as well as asbestos exposure. The mean number of years since first asbestos exposure was 32.6 years. The X-rays were interpreted independently by three NIOSH certified B-reader who were unaware of the subjects' identities and clinical and occupational histories using the 1980 ILO classification system for pneumoconiosis. The degree of interobserver agreement was assessed by a kappa type statistical analysis. The three readers agreed to within +/-1 minor profusion category on 67% of the X-ray films. The discrepancies were primarily in the 0/0 and 1/0 categories. Interobserver agreement on the presence of pleural thickening was good, having a kappa value (k- value) of 0.50. Agreement on the width of pleural thickening was only fair, k-value 0.35. The readers showed excellent agreement on the presence of pleural calcification and good agreement on the extent of pleural calcification, k-values 0.62 and 0.48, respectively. The authors conclude that overall agreement among experienced B-readers using the 1980 ILO classification system for evaluating radiographic opacities in a referred population appears to be good.
Chest-X-rays; Lung-lesions; Statistical-analysis; Disabled-workers; Medical-examinations; Occupational-respiratory-disease; Respiratory-system-disorders; X-ray-diagnosis;
DHHS (NIOSH) Publication No. 90-108
Asthma and Chronic Obstructive Pulmonary Disease; Disease and Injury; Respiratory-system-disorders;
Proceedings of the VIIth International Pneumoconioses Conference